Wang Yanjun,Kong Yanxia,Quan Xueli,et al.A child with massive hemoptysis successfully rescued by extracorporeal membrane oxygenation and literature review[J].Journal of Clinical Pediatric Surgery,,21():380-385.[doi:10.3760/cma.j.cn101785-202107055-016]
A child with massive hemoptysis successfully rescued by extracorporeal membrane oxygenation and literature review
- Keywords:
- Hemoptysis/TH; Extracorporeal Membrane Oxygenation
- Abstract:
- ObjectiveTo summarize the indications and anticoagulation managements of extracorporeal membrane oxygenation (ECMO) for hemoptysis patients.MethodsA successful case of ECMO in the treatment of massive hemoptysis at our hospital was analyzed and the relevant literature retrieved for reviewing. The databases of PubMed, Science Citation Index and Embase were searched with the keywords of "massive hemoptysis; extracorporeal membrane oxygenation" or "hemoptysis; ECMO" in Wanfang, CNKI and Biomedical Literature Service System. The searching time was up to June 2021. Adult cases and duplicate literature were excluded and the search results summarized. ResultsA total of 6 literatures and 13 children were retrieved along with 1 child at our department. A total of 14 children were analyzed. There were 6 boys and 8 girls with an average age of 8.9(5/52-15) years. The etiologies were sepsis (n=2), autoimmune disease (n=8), fungal infection (n=1), vascular malformation (n=2) and pulmonary hemosiderosis (n=1). All 14 children received ECMO treatment due to massive hemoptysis and respiratory failure with an average on-machine time of 6.4 days. One child underwent arterial-venous (V-A) mode due to cardiac arrest while the remainders venous-venous (V-V) mode. Heparin anticoagulation was confirmed (n=13) and unknown (n=1). Hemostatic agent of tranexamic acid was used (n=1), not used (n=11) and unknown (n=2). Four cases were operated, including lobectomy (n=2), endovascular stenting plus vascular embolization (n=1) and vascular embolization (n=1). The remainders were not operated. No massive bleeding occurred during ECMO. ConclusionMassive hemoptysis is rare in children. For children with life-threatening massive hemoptysis, ECMO provides a new possible rescue method. Furthermore, ECMO under systemic heparinization poses no elevated risk of bleeding.
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Memo
收稿日期:2021-07-30;改回日期:。
基金项目:河南省医学科技攻关计划(联合共建项目) LHGJ20190976
通讯作者:王洁,Email:wangjie1965319@163.com